| NPI | 1629100813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C2-0008977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS008923L) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2019-02-11 |