| NPI | 1154362523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 059135) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 70158) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2011-02-18 |