| NPI | 1326208752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO154358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 4002) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2012-11-06 |