| NPI | 1306943295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2009-1145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 3920) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-09-27 |