| NPI | 1003473380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO211142) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 417105) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-04-16 |