| NPI | 1508186859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 32729) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL32729) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2022-02-07 |