| NPI | 1215081849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17463) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-9597) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-02-17 |