| NPI | 1730318783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2012023601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009015675) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2016-11-16 |