| NPI | 1962799734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 72373) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 005288) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2016-05-04 |