| NPI | 1992021745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD155965) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2010-00633) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2023-03-02 |