| NPI | 1720219249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-04118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8694) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2014-04-25 |