| NPI | 1922320217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 17833) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17833) |
| Enumeration Date | 2010-02-27 |
| Last Update Date | 2016-03-31 |