| NPI | 1366539355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101257765) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 056895) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-07-28 |