| NPI | 1003170176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1330) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME DO2536) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2021-11-09 |