| NPI | 1154633584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 04232) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8935) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2013-09-26 |