| NPI | 1578123956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 322278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 66558) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-08-09 |