| NPI | 1760757033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12227) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO2742) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2017-03-15 |