| NPI | 1619084308 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 33323) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 049713) | 
| Enumeration Date | 2006-08-25 | 
| Last Update Date | 2023-07-13 |