| NPI | 1902971641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101015757) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101015757) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2013-06-10 |