| NPI | 1659475143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 6882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9300421) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2014-08-06 |