| NPI | 1669630299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2010-00888) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2021-05-07 |