| NPI | 1669477972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 101096) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 02941) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2016-10-04 |