| NPI | 1477527299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY TL1383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200400810) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2022-02-23 |