| NPI | 1578903035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 51930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2016-01962) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-02-03 |