| NPI | 1356696264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 73470) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL12424) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2024-05-23 |