| NPI | 1710077466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 37506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 010123633A) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-06-11 |