| NPI | 1316908387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 23744) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 35706) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2018-04-10 |