| NPI | 1699157917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301108229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D85644) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-08-12 |