| NPI | 1487609533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2006-01149) |
| Additional Taxonomies | 174400000X Specialist (Licence: NH 015418) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-06-20 |