| NPI | 1982702486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.204101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 00027672) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-11-04 |