| NPI | 1306827928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2007-01026) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101-231623) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2021-05-27 |