| NPI | 1073098794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 9421327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9421327) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |