| NPI | 1235172842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A-2282-19) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3986) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2019-10-31 |