| NPI | 1366424558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MT 10036) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 10036) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2019-04-01 |