| NPI | 1417939661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 223219) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017130) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-06-16 |