| NPI | 1356706626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC P015811) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P010109) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2021-03-12 |