| NPI | 1134578537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 15356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14150) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2020-09-24 |