| NPI | 1518180579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VI 1762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2005-0360) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-10-26 |