| NPI | 1124016928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 02215) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 2215) |
| 207Q00000X Family Medicine (Licence: SD 4034) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-05-07 |