| NPI | 1053415158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS009262L) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2021-12-23 |