| NPI | 1891179198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 30972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7397) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2018-07-25 |