| NPI | 1366704017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-12212) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1258) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2015-09-25 |