| NPI | 1083639363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 67923) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 7752) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-09-16 |