| NPI | 1609432350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023012029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11443) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2023-09-19 |