| NPI | 1750720637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014022140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013017865) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2022-02-18 |