| NPI | 1295793917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200100810) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200100810) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2019-08-14 |