| NPI | 1003010463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-02044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 52437) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2018-11-14 |