| NPI | 1821319955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 40014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8970) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2024-04-16 |