| NPI | 1487769444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2011034014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 228481) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-12-15 |