| NPI | 1386057800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 14787) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL13260) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-03-28 |