| NPI | 1629214937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 33767-020) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WI 33767-020) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2021-01-12 |