| NPI | 1063687747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-00337) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 148686) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2020-10-25 |