| NPI | 1770084394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD 000000) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2020-09-28 |