| NPI | 1831206739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 19976) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 30664) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2014-05-13 |