| NPI | 1316995541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 051521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME101957) |
| 207Q00000X Family Medicine (Licence: HI md-16135) | |
| 207Q00000X Family Medicine (Licence: CA a87729) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2013-03-12 |