| NPI | 1467942227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD203802) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11105) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2021-11-01 |