| NPI | 1588684534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101241416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 33187) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-08-09 |