| NPI | 1265952543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301502552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301112667) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2020-10-30 |