| NPI | 1821210956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO28296) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-09-06 |