| NPI | 1295221760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101026312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 1023114634) |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2021-06-01 |