| NPI | 1164050878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 90111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 260773) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2023-10-04 |