| NPI | 1558891226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 60431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2020-0093) |
| 207Q00000X Family Medicine (Licence: NM RS2017-0542) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2021-05-13 |