| NPI | 1093760324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2013-00080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 2054) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-11-21 |