| NPI | 1710942974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 044181) |
| 207Q00000X Family Medicine (Licence: MN 42735) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-05-09 |