| NPI | 1083619589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 20918) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.020918) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-02-20 |