| NPI | 1689828006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301096299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 52350) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2011-08-10 |