| NPI | 1376258517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD219162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2022-1188) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2024-09-04 |