| NPI | 1669738712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-01208) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD171385) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2021-04-01 |