| NPI | 1891993317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 26119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 5684) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2019-07-19 |