| NPI | 1639104698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A98064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-13767) |
| 207Q00000X Family Medicine (Licence: AZ 35781) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-02-12 |