| NPI | 1245550094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 4208) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8913) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2013-08-07 |