| NPI | 1346451234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 046339) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116017095) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-09-03 |