| NPI | 1841291382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 20365) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2000-00272) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2021-02-08 |