| NPI | 1255995155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 41283) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GU TLL-2022-003) |
| 207Q00000X Family Medicine (Licence: CA A182562) | |
| 207Q00000X Family Medicine (Licence: TX V1799) | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2024-06-12 |