| NPI | 1568087112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL83219) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2023-01123) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2023-05-22 |