| NPI | 1154948735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 71310) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP8920) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2025-02-24 |