| NPI | 1770696262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-01803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 156858) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-02-06 |