| NPI | 1336702513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-16543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R77321) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2022-09-06 |