| NPI | 1912347303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID MRM-1327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 9694122-1205) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2018-05-01 |