| NPI | 1184061731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 76347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN18817) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2020-10-16 |