| NPI | 1013997493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2007035506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 1873) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2009-07-22 |