| NPI | 1477781995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 39896) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2012-02034) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2016-07-12 |