| NPI | 1609892413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD177584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-0872) |
| 207Q00000X Family Medicine (Licence: TX N-3251) | |
| 207Q00000X Family Medicine (Licence: ID M-10113) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-06-17 |