| NPI | 1740319904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MMD.36408MD) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2008-00306) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2015-03-02 |