| NPI | 1417991845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200600657) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2006-00657) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-07-12 |