| NPI | 1871971168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 52089) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 209264) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2019-12-04 |