| NPI | 1992797880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010018310) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 35759) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2013-09-24 |