| NPI | 1417991092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 68929) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 31352) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-10-05 |