| NPI | 1386628709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME123410) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 056040) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2015-08-05 |