| NPI | 1780838789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: UT 7152185-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 7152185-1204) |
| 208D00000X General Practice (Licence: UT 7152185-1204) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2022-04-27 |