| NPI | 1013964261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO1296) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 0S 9130) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-02-14 |