| NPI | 1356756266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-04758) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10080) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-10-02 |