| NPI | 1619941473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.22798) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 056570) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2014-08-01 |