| NPI | 1538459292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 77256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD20140703) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2019-10-30 |