| NPI | 1063034296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102207855) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101026867) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-01-27 |