| NPI | 1578507968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 27043) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9901364) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-01-20 |