| NPI | 1699934596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 53523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2011-0469) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-12-14 |