| NPI | 1639229479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200400570) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 200400570) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-05-04 |