| NPI | 1285854844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD170193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 41622) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-10-19 |