| NPI | 1457347304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 11497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 34384) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2022-10-20 |