| NPI | 1033157086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-26808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042-0011481) |
| 207Q00000X Family Medicine (Licence: MO 2019014153) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2022-01-27 |