| NPI | 1497952360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO 152040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R1084) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-06-23 |