| NPI | 1194246967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5151010884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023329) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-01-04 |