| NPI | 1386887842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 79954) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.204316) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2022-09-22 |