| NPI | 1548772650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL U04643) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2020-09-09 |