| NPI | 1487727202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01987) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS1019) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-04-23 |