| NPI | 1841464591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO04416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT011926) |
| 207Q00000X Family Medicine (Licence: IA 4416) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2018-11-08 |