| NPI | 1669420469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9701220) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 64251) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-08-10 |