| NPI | 1689991564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 76688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 206195) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2019-10-10 |