| NPI | 1164653820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8718) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2021-03-22 |