| NPI | 1285729939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS6543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203138) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-07-15 |