| NPI | 1740629815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015021030) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013020295) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2020-10-06 |