| NPI | 1235146184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME04887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101048752) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |