| NPI | 1336140243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME99390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200501100) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-03-06 |