| NPI | 1114905825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD27438) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60234868) |
| 207Q00000X Family Medicine (Licence: ID M-11555) | |
| 207Q00000X Family Medicine (Licence: FL ME91071) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2012-02-09 |