| NPI | 1508091489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-00275) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 57322-20) |
| 207Q00000X Family Medicine (Licence: ME MD21574) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2024-06-04 |