| NPI | 1497804421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 28101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2010-01846) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2014-02-04 |