| NPI | 1922074475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 28816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238238) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-01-25 |