| NPI | 1225141211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 86172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 21721) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-10-31 |