| NPI | 1861492498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME99356) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: AL 13200) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2021-12-16 |