| NPI | 1093079204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 74101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL4519) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2016-01-04 |