| NPI | 1114957032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 23348) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 230659) |
| 207Q00000X Family Medicine (Licence: AL 23102) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-02-06 |