| NPI | 1619239449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 078967) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 054349) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2021-01-21 |