| NPI | 1568982262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301501391) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301113181) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2020-10-19 |