| NPI | 1194145359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 61159) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2022-02-04 |