| NPI | 1740469741 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 49861) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 49861021) | 
| Enumeration Date | 2007-10-26 | 
| Last Update Date | 2023-03-07 |