| NPI | 1336134261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0102207401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017551) |
| 207Q00000X Family Medicine (Licence: KS 05-27916) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 5101017551) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2022-10-20 |