| NPI | 1710952205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-00827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 12580) |
| 207V00000X Obstetrics & Gynecology (Licence: SC 12580) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2013-01-07 |