| NPI | 1972858587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 44712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX q4583) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2023-10-18 |