| NPI | 1629146816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS13503) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 45544) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-07-26 |