| NPI | 1992815625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 20980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 051027) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-05-12 |