| NPI | 1760484018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C20005526) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H0054380) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2011-05-19 |