| NPI | 1497010524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 34712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL 34712) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2021-01-08 |