| NPI | 1881037927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-43799) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 63084) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-03-17 |