| NPI | 1871889303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014021718) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 248385) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2018-05-10 |