| NPI | 1578124442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2022-1201) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2019-0557) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2022-08-23 |