| NPI | 1023018082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-01472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 22642) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-03-08 |