| NPI | 1053725069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17264) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN20444) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2022-10-11 |