| NPI | 1053739623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81133-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1725) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-08-06 |