| NPI | 1023372042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO3110) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-03-14 |