| NPI | 1073834305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: AR 9034) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101254010) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2018-08-08 |