| NPI | 1548347040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200701097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL27701) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-08-13 |