| NPI | 1942289517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK MEDS6502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME84803) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-01-12 |