| NPI | 1306888433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.024416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 40645) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2012-08-14 |