| NPI | 1659631778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 67201) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60288572) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2020-02-27 |