| NPI | 1447512132 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015026151) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2012016523) | 
| Enumeration Date | 2012-06-09 | 
| Last Update Date | 2022-02-17 |