| NPI | 1720052400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D92021) |
| Additional Taxonomies | 174400000X Specialist (Licence: DE C1-0006569) |
| 207Q00000X Family Medicine (Licence: DE C1-0006569) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-07-20 |