| NPI | 1295998953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301109197) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 10080939) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2016-08-24 |