| NPI | 1063775427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 102892) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: MA 4951) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2024-05-22 |