| NPI | 1396857041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 33470) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200301476) |
| 207Q00000X Family Medicine (Licence: GA 069490) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-01-12 |