| NPI | 1093245094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 15477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14623) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2020-08-06 |