| NPI | 1649387887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS10854) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101015955) |
| 207Q00000X Family Medicine (Licence: NC 2007-01425) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-05-31 |