| NPI | 1578944476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05172) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10388) |
| 207Q00000X Family Medicine (Licence: IA R-10767) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-04-30 |