| NPI | 1942275045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2013038957) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101055692) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2021-04-19 |