| NPI | 1306108402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2017-0969) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 27567) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2019-10-14 |