| NPI | 1669672523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 25177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 231161) |
| 207Q00000X Family Medicine (Licence: MI 4301083894) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2011-08-23 |