| NPI | 1659543981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS10679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL US1501) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2010-01-14 |