| NPI | 1285927608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 26959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 62853-20) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2023-04-03 |