| NPI | 1073841029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117798) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 48845) |
| 207QA0000X Family Medicine Adolescent Medicine (Licence: CT 48845) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: CT 48845) | |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2022-01-27 |