| NPI | 1275735748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 12153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD27510) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2011-08-05 |