| NPI | 1083608954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0065437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0007183) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2017-11-22 |