| NPI | 1902126956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-00374) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME110894) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2024-10-30 |