| NPI | 1689015638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 76156) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 6688) |
| Enumeration Date | 2013-07-07 |
| Last Update Date | 2019-10-15 |