| NPI | 1174654479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0013693) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A93304) |
| 207Q00000X Family Medicine (Licence: PA MD434212) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2023-05-11 |