| NPI | 1992250336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 71496) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301109854) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2019-09-30 |