| NPI | 1932191400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-01882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME60233) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2024-09-30 |