| NPI | 1891059606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 04501) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-9444) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2015-11-30 |