| NPI | 1750733911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 15924) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND PT15924) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2019-12-17 |