| NPI | 1548466014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 170865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 13617) |
| 207Q00000X Family Medicine (Licence: NE NE24952) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-04-26 |