| NPI | 1831189984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 060050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 00024088) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2018-04-13 |