| NPI | 1114374006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD194566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ D06288314) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2021-02-15 |