| NPI | 1326020876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 057147) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 91721) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2009-05-17 |