| NPI | 1154441822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009034588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 264) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-12-01 |