| NPI | 1457346603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-15413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 52099-20) |
| 207Q00000X Family Medicine (Licence: WA MD60470272) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2023-04-04 |