| NPI | 1447249966 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: UT F7736) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: TX F7736) | 
| Enumeration Date | 2005-10-18 | 
| Last Update Date | 2016-03-25 |