| NPI | 1639161102 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA GA029884) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 029884) | 
| Enumeration Date | 2005-08-19 | 
| Last Update Date | 2016-11-16 |