| NPI | 1437131950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OR MD167602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 224072) |
| 207Q00000X Family Medicine (Licence: CT 045469) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2015-06-10 |