| NPI | 1417334285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 80730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 54857) |
| 207Q00000X Family Medicine (Licence: AZ R74970) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2018-10-12 |