| NPI | 1710917026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 36911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23772) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-05-28 |