| NPI | 1871701300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: AZ 25817) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 25817) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-05-01 |