| NPI | 1821404260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 14694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL13294) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2018-03-17 |