| NPI | 1194089789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MD34758) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL34758) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2016-04-08 |