| NPI | 1023094158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 049525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD12263) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2012-11-13 |