| NPI | 1225390875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 13437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND TRL12339) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2020-11-23 |