| NPI | 1184787673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MS 17415) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17415) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: MS 17415) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-01-08 |