| NPI | 1023687217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024030678) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP9082) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2024-09-26 |