| NPI | 1376993428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351037574) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301110006) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2019-01-23 |