| NPI | 1508862756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 36988) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 35894) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2023-12-05 |