| NPI | 1114155702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 068656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MD31877) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2015-12-12 |