| NPI | 1720347651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12246) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO2743) |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2022-06-07 |