| NPI | 1609872720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 22582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9901115) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2012-09-26 |