| NPI | 1760680235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 37889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R8059) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2012-05-17 |