| NPI | 1295892305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 59416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39859) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-01-12 |