| NPI | 1417959230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-00523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200500523) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-04-08 |