| NPI | 1528265998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 30103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL30103) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2023-06-29 |