| NPI | 1306817721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 44744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 32964) |
| 207P00000X Emergency Medicine (Licence: MN 40318) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2011-09-26 |