| NPI | 1245494525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 69730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 243660) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2015-03-03 |