| NPI | 1619953015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 17349) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 22983) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2023-05-24 |