| NPI | 1114034857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 27361) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 22907) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |