| NPI | 1669566030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD152338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2004-0477) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-01-10 |