| NPI | 1619380573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 37015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL30715) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2024-08-12 |