| NPI | 1932383775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 22450) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2007-0508) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2022-09-02 |