| NPI | 1902003262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RTP002343) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2013-07-16 |