| NPI | 1467089474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-01180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 83252) |
| 208D00000X General Practice (Licence: SC 83252) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2023-09-08 |