| NPI | 1104948892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2009-01199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 135590) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-11-28 |