| NPI | 1023321585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8921) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2014-11-12 |