| NPI | 1760692743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 19963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 27198) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-09-26 |