| NPI | 1558894477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 40999) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2019-01299) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-08-21 |