| NPI | 1477536761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MI 4301091765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 44008-020) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2009-04-22 |