| NPI | 1649489683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OR MD126287) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OR LL16333) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-03-24 |