| NPI | 1194856542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 3882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 4286A) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2011-10-20 |