| NPI | 1275604316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 55700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 6412) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2018-11-12 |