| NPI | 1821067000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101253061) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301065739) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2014-01-09 |