| NPI | 1821403593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015026152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014019168) |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2020-11-10 |