| NPI | 1417039447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 9679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 32678) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-03-29 |