| NPI | 1295154300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01617) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 133746) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2022-07-26 |