| NPI | 1255610580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D77284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 6550) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2016-10-04 |