| NPI | 1124257282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 63630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 32040) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2025-02-17 |