| NPI | 1528155280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO21207) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 0021207) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-06-28 |