| NPI | 1104812494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 26797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 057050) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2023-08-16 |