| NPI | 1700064839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD125759) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 002208) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2011-07-14 |