| NPI | 1033402375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-41903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 59929) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2021-08-20 |