| NPI | 1972679165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H0055542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC D032891) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-11-10 |