| NPI | 1083678551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 26642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 3985) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2014-06-30 |