| NPI | 1497713820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-01251) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 24034) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2016-04-12 |