| NPI | 1992026777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 263099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60155964) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2015-09-10 |