| NPI | 1215099668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD035435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K9030) |
| 207Q00000X Family Medicine (Licence: CA G47212) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |