| NPI | 1609031657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 066960) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 003467) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2019-10-10 |