| NPI | 1093078578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0750) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRO-1246) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2015-12-09 |