| NPI | 1306952619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 14450) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA a52665) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-11-05 |