| NPI | 1558803247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 68230) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2023-01-12 |