| NPI | 1578654562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 51667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 41212) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-02-23 |