| NPI | 1972701043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-01860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 33111) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-02-20 |