| NPI | 1114278124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017020529) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS 12551) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2020-07-28 |