| NPI | 1104576677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 87692) |
| Additional Taxonomies | 208D00000X General Practice (Licence: SC 87692) |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2024-03-19 |