| NPI | 1528355591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 13200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL11849) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2021-07-16 |