| NPI | 1790939288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39262) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8495) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2012-06-21 |