| NPI | 1235392788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2011018270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2008015886) |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2014-10-09 |