| NPI | 1891948873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-00484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO155698) |
| 207Q00000X Family Medicine (Licence: VA 0102206903) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2024-08-18 |