| NPI | 1073593737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5866) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R9F01) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2007-07-08 |