| NPI | 1285252767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81757-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL16559) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2024-09-17 |