| NPI | 1376995852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R10706) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-02-12 |