| NPI | 1760447387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 47822) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 61092627 1205) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2015-05-14 |