| NPI | 1992768469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD SD3600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 3600) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-04-27 |