| NPI | 1033212915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 40562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO T2005015438) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-02-25 |