| NPI | 1316100894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2011014011) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2008018039) |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2017-03-15 |