| NPI | 1215314620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 69471) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74973) |
| 207Q00000X Family Medicine (Licence: NV 17975) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2023-10-11 |