| NPI | 1770598427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 36783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 10907) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2024-06-03 |