| NPI | 1134481849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1131) |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2021-01-27 |