| NPI | 1831176460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 21332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2005019590) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2016-09-12 |