| NPI | 1376554568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 8597) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 40276) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-10-01 |