| NPI | 1821385659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-00787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL1484) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-04-09 |