| NPI | 1972661692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 055194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME86431) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2009-06-18 |