| NPI | 1083811954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD179435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 81352) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2018-01-31 |