| NPI | 1326100561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MA 39392) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 39392) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 39392) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-08-09 |