| NPI | 1417362880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2016025180) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 0) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-11-12 |