| NPI | 1710186812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200700404) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.35384) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2019-10-01 |