| NPI | 1780792457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD10944) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 10944) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-05-19 |