| NPI | 1043698939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 52087) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-12-02 |