| NPI | 1821308032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR D0163300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013874) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2023-03-24 |