| NPI | 1275731580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 62809) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL 30124) |
| Enumeration Date | 2007-07-08 |
| Last Update Date | 2020-10-06 |