| NPI | 1114996428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 41146) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2010-01-12 |