| NPI | 1982621330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200500268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 21977) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-10-25 |