| NPI | 1245764893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-02296) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 64096) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2020-08-18 |