| NPI | 1710096607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK MEDS5523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 11450) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-05-22 |