| NPI | 1992739320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD CP000216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD R023144) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-07-29 |