| NPI | 1518992254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 21160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-00368) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-12-28 |