| NPI | 1275649105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 87290) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 156314) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-12-07 |