| NPI | 1578536504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 81574) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200501189) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-01-24 |