| NPI | 1467445072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 12926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200401008) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2011-01-14 |