| NPI | 1053970426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2020037120) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019018906) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2022-06-30 |