| NPI | 1265743348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 34591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD162973) |
| 207Q00000X Family Medicine (Licence: ID M-1119) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-06-15 |