| NPI | 1912228941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 069580) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 1390) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2017-02-03 |