| NPI | 1073570297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 0000036763) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 040253) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2013-04-10 |