| NPI | 1083613004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 25928) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0072229) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-11-09 |