| NPI | 1629418215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 107950) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 7853) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2022-07-21 |