| NPI | 1679869325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-11875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-1170) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-03-08 |