| NPI | 1033347562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD169044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 18705) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2020-05-08 |