| NPI | 1427675644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301509559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 8801) |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2023-08-24 |