| NPI | 1720116452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 83851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME105139) |
| 207Q00000X Family Medicine (Licence: SC LL28993) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-04-08 |