| NPI | 1043693849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 11116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015021150) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2018-09-07 |