| NPI | 1346215852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 13332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 49112) |
| Enumeration Date | 2006-02-18 |
| Last Update Date | 2017-02-15 |