| NPI | 1043658271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 56800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 029-T1) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-07-14 |