| NPI | 1811093255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 10175) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 73829) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-07-14 |