| NPI | 1912388943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2018025922) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL37642) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-03-03 |