| NPI | 1114488665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2022033075) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO TBD) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2022-10-31 |