| NPI | 1477870020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 68924) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 164609) |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2015-11-05 |