| NPI | 1366469280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 67690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 16072) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-10-08 |