| NPI | 1124373642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H75358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C20010184) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2015-11-06 |