| NPI | 1831384189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200800946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 28108) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2008-10-16 |