| NPI | 1093209603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116031595) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2023-10-21 |