| NPI | 1902082233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H83926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2012-01916) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2018-05-30 |