| NPI | 1174783211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 11974) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8325) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2012-01-19 |