| NPI | 1386686434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-24472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R1H49) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-09-13 |