| NPI | 1275832057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 54356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 15180A) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2023-01-20 |