| NPI | 1558853788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 52525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2024-02187) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-09-05 |