| NPI | 1124558168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101023406) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5315086887) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-06-13 |