| NPI | 1356401749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200301233) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS9461) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-09-28 |