| NPI | 1568768133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 068354) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2014-08-21 |