| NPI | 1104865658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD165194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ AZ26887) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-12-05 |