| NPI | 1215147905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 28819) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L2630) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-12-15 |