| NPI | 1508378118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 323688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 9560) |
| Enumeration Date | 2017-11-05 |
| Last Update Date | 2024-10-09 |