| NPI | 1053398784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A73948) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 15005) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2011-06-10 |