| NPI | 1982919585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 12688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL11535) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2013-07-16 |