| NPI | 1487883104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301094500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5315041175) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2014-01-22 |