| NPI | 1962599399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 2188) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101013008) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-02-03 |