| NPI | 1346234291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 50463) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 9301073594) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2013-04-03 |