| NPI | 1871506063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 060435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME95582) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-10-12 |