| NPI | 1679867709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 57135) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2014-00893) |
| 207Q00000X Family Medicine (Licence: NC 173043) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-11-03 |