| NPI | 1245545235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MD H0077515) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OT013788) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2016-04-04 |