| NPI | 1689644015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 20262) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 20262) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-09-24 |