| NPI | 1154642577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2013013916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010017229) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2018-02-05 |