| NPI | 1083688576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO1559) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2010-10-15 |