| NPI | 1619445459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11000091) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 222740) |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2024-02-19 |