| NPI | 1548286065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.06746R) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA L06746R) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2010-03-16 |