| NPI | 1285623439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 5937) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 5215) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2021-02-15 |