| NPI | 1629024617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 295484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 40908) |
| 207Q00000X Family Medicine (Licence: CA A73161) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-04-02 |