| NPI | 1992067300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-01361) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 34799) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-04-24 |