| NPI | 1023195898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME68494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD27034) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-12-08 |