| NPI | 1982775417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0073580) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 49157) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-03-10 |