| NPI | 1407878655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D80691) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 25772) |
| 207Q00000X Family Medicine (Licence: GA 055652) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-12-11 |