| NPI | 1700868353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME112763) |
| Additional Taxonomies | 174400000X Specialist (Licence: SD 5318) |
| 208600000X Surgery (Licence: FL ME112763) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2022-10-12 |