| NPI | 1982634028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 47600) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN 36832) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-10-03 |