| NPI | 1588911580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015021643) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP number: 6811) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2015-11-19 |