| NPI | 1730475336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 248569) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2021-03-31 |