| NPI | 1346760246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-02821) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL41062) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |