| NPI | 1154596914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 30193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.2896R) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2011-11-23 |