| NPI | 1326195777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 3668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 10853) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2012-05-07 |