| NPI | 1710111489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-01668) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2010-01668) |
| 208D00000X General Practice (Licence: NC 2010-01668) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2024-05-13 |