| NPI | 1912072455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CT 033793) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 033793) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |