| NPI | 1407857022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0029209) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: VA 0101248787) |
| 207QA0505X Family Medicine Adult Medicine (Licence: DC MD039437) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2011-12-04 |