| NPI | 1194219501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301505114) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301114535) |
| 207Q00000X Family Medicine (Licence: MI 4351029128) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2021-08-23 |