| NPI | 1508963992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 88-260) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NM 88260) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-02-05 |