| NPI | 1093107583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 81740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 3208) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2020-12-16 |