| NPI | 1184824633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.203042) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 674-L) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2017-05-05 |