| NPI | 1962487975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME81844) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME81844) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2018-02-27 |