| NPI | 1669868956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-00763) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 1669868956) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-04-05 |