| NPI | 1114189024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MA 204630) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 204630MB0422) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2021-06-30 |