| NPI | 1982710893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS7080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 153618) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2009-10-15 |