| NPI | 1821278698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30838) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA BT4601692-8387) |
| 208600000X Surgery (Licence: IL 125055402) | |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2014-06-13 |