| NPI | 1831126200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200500250) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 200500250) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2017-01-06 |