| NPI | 1396894077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 82199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 35910-020) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2009-09-24 |