| NPI | 1912962788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 5085) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 22311) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-11-15 |