| NPI | 1558365049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 34703) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 74480) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2019-02-26 |