| NPI | 1265720395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 218279362) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101019408) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2017-01-16 |