| NPI | 1912055609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 33111) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 33111) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-08-05 |