| NPI | 1598865321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD205034) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 6050) |
| 207Q00000X Family Medicine (Licence: ID M-12651) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-04-27 |