| NPI | 1699113126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 83285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04670) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2021-06-07 |