| NPI | 1396701090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010002243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME88661) |
| 207Q00000X Family Medicine (Licence: KS 04-34089) | |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2021-10-11 |