| NPI | 1699714782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD27307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 212607) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-07-19 |