| NPI | 1063037000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81246-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 01321565) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2025-06-04 |