| NPI | 1023092525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO-561) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-01-05 |