| NPI | 1215109509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-01420) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 139328) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2023-03-07 |