| NPI | 1003306424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS17667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL.0007293) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2021-08-27 |