| NPI | 1255348710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 37349) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 40504) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-08-29 |