| NPI | 1073809232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-49461) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 6049) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-10-18 |