| NPI | 1568483980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL FLOS8766) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-02-11 |