| NPI | 1932152121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9601158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 20238) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-10-21 |