| NPI | 1619006152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200801719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 133986) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-10-29 |