| NPI | 1619219169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-02103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 39892) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2023-05-23 |