| NPI | 1770681405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 346000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.5581VP) |
| 207Q00000X Family Medicine (Licence: NC 2015-02190) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-04-09 |