| NPI | 1063582039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 40720) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M7275) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2015-08-17 |