| NPI | 1508087164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 10843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 24677) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-04-15 |