| NPI | 1366018012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 86050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL86050) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-09-11 |