| NPI | 1518196179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101019550) |
| Additional Taxonomies | 208800000X Urology (Licence: PA OT013283) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2016-04-20 |