| NPI | 1356870299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 83049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 225499) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-02-01 |