| NPI | 1497333702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01546) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101279091) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-08-01 |