| NPI | 1396789574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD28960) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 224287) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-04-07 |