| NPI | 1457655482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 12489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 10701) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2015-09-15 |