| NPI | 1891737151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME90490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 23278) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2015-03-09 |