| NPI | 1114368115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA R9793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04596) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2024-11-06 |