| NPI | 1750641759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC e45u6u6 k) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 25265) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2018-04-12 |