| NPI | 1275864712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010021799) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO PENDING) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2020-11-20 |