| NPI | 1063708055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-42760) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 005240) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2018-07-09 |