| NPI | 1811263601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 19314) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.207879) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2022-03-17 |