| NPI | 1578697074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009022062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E5248) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2015-04-14 |