| NPI | 1801923560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 1644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-00139) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2021-05-14 |