| NPI | 1811176704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 7823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL10545) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2016-06-01 |