| NPI | 1932588100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 72691) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2020-05-13 |