| NPI | 1245441955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.13403R) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 13403) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2011-10-03 |