| NPI | 1346739414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 75111-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN26145) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2021-05-28 |