| NPI | 1023227527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-02450) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 36612) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-05-26 |