| NPI | 1346500048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.207748) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 183239) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2019-05-01 |