| NPI | 1316069933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 129166) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2011-08-11 |