| NPI | 1265440994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 16258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 36883) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-05-14 |