| NPI | 1699858837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC APN1127) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN100396NP) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2012-11-12 |