| NPI | 1306376447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 74058) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 129-T2) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-05-07 |