| NPI | 1881645562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 33104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-01138) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-01-04 |