| NPI | 1417452095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D91429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 238144) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2021-09-13 |