| NPI | 1346688512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 85153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 28296) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 28296) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-09-06 |