| NPI | 1871525303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR md173840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 228437) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-07-02 |