| NPI | 1821051467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01805) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 24444) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2021-11-22 |