| NPI | 1013913854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME95562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 49769) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-11-19 |