| NPI | 1346636297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 2047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 66889-21) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-07-07 |