| NPI | 1255561379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 89269) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 31828) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2021-12-16 |