| NPI | 1083712665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO945) |
| 207Q00000X Family Medicine (Licence: GA 051694) | |
| 207Q00000X Family Medicine (Licence: NY 197975) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-21 |