| NPI | 1609864628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD d0076061) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 2007-01439) |
| 208D00000X General Practice (Licence: GA 056784) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-11-19 |