| NPI | 1851578256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME105153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 002462) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2009-11-18 |