| NPI | 1265477145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 249409) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101229728) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2012-09-10 |