| NPI | 1043541642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 255975) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10034419) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2013-07-01 |