| NPI | 1750613618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-43443) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 26948) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2019-11-11 |