| NPI | 1760794895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.320769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-12635) |
| 207Q00000X Family Medicine (Licence: MA 242220) | |
| 207Q00000X Family Medicine (Licence: WA MD60715630) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2023-02-02 |