| NPI | 1821053406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 38204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-28346) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2018-07-02 |