| NPI | 1962594390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 24717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 7250) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2013-12-20 |