| NPI | 1780629758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2018030096) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS013118) |
| 207Q00000X Family Medicine (Licence: TX N7930) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2023-06-12 |