| NPI | 1083913479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 344486) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015010244) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2024-11-26 |