| NPI | 1831353093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-02131) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 62931) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2022-07-22 |