| NPI | 1184608184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 40912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 33434) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2012-09-07 |