| NPI | 1043248750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 002719) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2719) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2019-11-05 |