| NPI | 1558621185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16073) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04886) |
| 207Q00000X Family Medicine (Licence: PA OT014785) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2022-04-01 |