| NPI | 1689683054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 40841) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 40841) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-03-07 |