| NPI | 1821288077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 075161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2008-01550) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2017-03-16 |