| NPI | 1417951856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 24797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 29596) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-05-10 |