| NPI | 1770743627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 12124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD28353) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2014-09-19 |