| NPI | 1972828416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-03325) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 005901) |
| 207Q00000X Family Medicine (Licence: CA 20A13334) | |
| 207Q00000X Family Medicine (Licence: VA 0102203550) | |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2021-05-11 |