| NPI | 1225417769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 38223) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL38223) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2020-07-06 |