| NPI | 1124131784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60318447) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP00034) |
| 207Q00000X Family Medicine (Licence: CA 104973) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA A104973) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2013-07-17 |