| NPI | 1659655207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO2728) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2013-03-21 |