| NPI | 1033125117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 11554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 17375) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2017-10-30 |