| NPI | 1215963509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD27752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23396) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2022-02-04 |