| NPI | 1003225954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 1363) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO3890) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2019-08-01 |