| NPI | 1679626006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 35607) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD29194) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2025-01-27 |