| NPI | 1619046232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 16928) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101054578) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-09-24 |