| NPI | 1558373969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200500053) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 29596) |
| 207Q00000X Family Medicine (Licence: SC 13576) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2013-09-27 |