| NPI | 1376645549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 9400625) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 59247) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2014-06-05 |