| NPI | 1265608038 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.159561)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101256472)  | 
| 207P00000X Emergency Medicine (Licence: GA 065557)  | |
| 207Q00000X Family Medicine (Licence: GA 065557)  | |
| 207Q00000X Family Medicine (Licence: FL ME120943)  | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OH 35125100)  | |
| Enumeration Date | 2008-05-01 | 
| Last Update Date | 2025-06-18 |