| NPI | 1366711616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-12916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014004829) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2022-05-23 |