| NPI | 1629206503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 003793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 66322) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-03-14 |