| NPI | 1083148472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 70155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2020-00441) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2022-10-18 |