| NPI | 1720176290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301108856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 36066) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-12-20 |