| NPI | 1649472499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2018-0674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD166967) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-07-12 |