| NPI | 1639343189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD173816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2011-0679) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2019-11-15 |