| NPI | 1508206152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014034662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013020975) |
| 207Q00000X Family Medicine (Licence: AR E9708) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2018-03-17 |