| NPI | 1063093011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 9006) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2024-04-08 |