| NPI | 1043471329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-00384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116020530) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2011-06-10 |