| NPI | 1659363430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME99966) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 33926) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-10-30 |