| NPI | 1053318089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A74628) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD038413) |
| 207Q00000X Family Medicine (Licence: MD D63315) | |
| 207Q00000X Family Medicine (Licence: VA 0101246622) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2023-05-21 |