| NPI | 1538579271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 10716) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 0085) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2019-07-18 |