| NPI | 1376854588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 48434) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116022361) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2014-10-28 |