| NPI | 1629561766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101023975) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151011286) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2019-01-29 |