| NPI | 1063772309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 87451) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.31401) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2021-08-27 |