| NPI | 1861460883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 30390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC TL30390) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2021-12-14 |