| NPI | 1730400060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 004367) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2013-11-15 |