| NPI | 1740395722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39264) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 29772) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-04-30 |