| NPI | 1477592467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 51203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 216493) |
| 207Q00000X Family Medicine (Licence: MN 43414) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-01-08 |