| NPI | 1356724132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 38564) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL38564) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2020-11-06 |