| NPI | 1104449149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 35789) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 8713) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2025-01-30 |