| NPI | 1760703094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 67016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2012-02142) |
| 207Q00000X Family Medicine (Licence: GA 4138) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2019-11-25 |