| NPI | 1568606770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO173331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102202744) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2016-07-29 |