| NPI | 1417119348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0012985) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-01882) |
| 207Q00000X Family Medicine (Licence: MA 259345) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2022-06-15 |