| NPI | 1053371716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 35774) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 15004) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2011-05-03 |