| NPI | 1790076248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 37402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 173730) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2015-09-23 |