| NPI | 1306810858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 11828) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD23082) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-10-19 |