| NPI | 1104950096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: GA 61803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 61803) |
| 207Q00000X Family Medicine (Licence: SC LL 27322) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-01-03 |