NPI | 1407016454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: PA MD442500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD442500) |
2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME115615) | |
208600000X Surgery (Licence: PA MT189472) | |
208600000X Surgery (Licence: FL ME115615) | |
Enumeration Date | 2008-06-12 |
Last Update Date | 2021-01-02 |