| NPI | 1164408126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK AK4562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 38153) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-08-22 |