| NPI | 1053502948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 40226) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A100472) |
| 208600000X Surgery (Licence: CA A100472) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2020-10-14 |