| NPI | 1053390542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: PA MD455783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H2874) |
| 207Q00000X Family Medicine (Licence: DE C1-0009780) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-03-31 |