| NPI | 1194786079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD28309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M8351) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2011-12-23 |