| NPI | 1740366988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 46190) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 4910) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-10-21 |