| NPI | 1194704346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2003-00263) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 20212) |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2025-01-22 |