| NPI | 1053313064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 2005-01324) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2005-01324) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-12-03 |