| NPI | 1730177064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45558) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01060997A) |
| 207Q00000X Family Medicine (Licence: VA 0101250049) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2016-06-21 |