| NPI | 1669597076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 2014-0495) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 7071) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2024-01-31 |