| NPI | 1740473651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WI 54768) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 38512) |
| 207Q00000X Family Medicine (Licence: SC 29167) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2024-09-30 |