| NPI | 1285815068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015215) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA ot011973) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2015-08-03 |