| NPI | 1336290782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 53060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 69357) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: FL ME53060) | |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2019-09-24 |