| NPI | 1154559920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 40401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD40401) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2019-08-06 |