| NPI | 1083804793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 4031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R8458) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2013-01-04 |