| NPI | 1164550893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME104983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 27568) |
| 207Q00000X Family Medicine (Licence: SC LL27568) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2024-01-19 |