| NPI | 1164644381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 10352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9601377) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |