| NPI | 1952662769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015011059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2012015734) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-10-05 |