| NPI | 1255823951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11255) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2020-02-10 |