| NPI | 1275285124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2021047578) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021047578) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |