| NPI | 1982667655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY TL8438) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 620) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2024-11-11 |