| NPI | 1447592134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 56028) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 6626) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2018-08-24 |