| NPI | 1548821010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301507705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351045592) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-02-26 |