| NPI | 1700092608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01064179A) |
| 207Q00000X Family Medicine (Licence: FL ME123825) | |
| 207Q00000X Family Medicine (Licence: OH 35.089202) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-05-25 |