| NPI | 1215010061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME95140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E4965) |
| 207Q00000X Family Medicine (Licence: AL MD27483) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2022-02-03 |