| NPI | 1194211714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-00961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL61176) |
| 207Q00000X Family Medicine (Licence: SC 61176) | |
| 207Q00000X Family Medicine (Licence: SC MD61176) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2022-12-21 |