| NPI | 1093854218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 31477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 41233) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-03-28 |