| NPI | 1811965833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-02093) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 032428) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2017-01-04 |