| NPI | 1700049079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-01448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 236981) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2023-03-16 |