| NPI | 1518557099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 4122) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 305193) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-09-22 |