| NPI | 1992868764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 98-00562) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 98-00562) |
| 207Q00000X Family Medicine (Licence: CA 54515) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2014-12-09 |