| NPI | 1720028491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS9309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS012612) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |