| NPI | 1598755001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 46021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 8912) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2014-02-19 |