| NPI | 1164739850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-01919) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 14465) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2020-10-25 |