| NPI | 1134113905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WA MD00041103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 5279439-1205) |
| 208600000X Surgery (Licence: AL 11633) | |
| 208600000X Surgery (Licence: LA 17373) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2008-02-14 |