| NPI | 1871931113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017011891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301111149) |
| Enumeration Date | 2013-06-09 |
| Last Update Date | 2018-10-09 |