| NPI | 1124465067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 74602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 74602) |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2016-08-26 |