| NPI | 1902034655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0101251908) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2015-07-14 |