| NPI | 1962722421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX P5473) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P5473) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2013-11-18 |