| NPI | 1740406289 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME116812) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME116812) | 
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2015-12-14 |