| NPI | 1861600975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17426) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 45479) |
| 207Q00000X Family Medicine (Licence: GA 69055) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-02-15 |