| NPI | 1598290561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 309034) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2022-00598) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2023-04-18 |