| NPI | 1194085365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101271545) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 17198) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2021-09-13 |