| NPI | 1316387194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 06292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 66164-20) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2016-09-14 |