| NPI | 1932411212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-04205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8937) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2019-11-25 |