| NPI | 1093747594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC TL28198) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-08-12 |