| NPI | 1023692480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD221377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS T-4333) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2024-09-18 |