| NPI | 1497987812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 11479) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 12484) |
| 207Q00000X Family Medicine (Licence: MN 65569) | |
| 207Q00000X Family Medicine (Licence: TN 69549) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2024-07-25 |