| NPI | 1619539418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351044634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301506077) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2021-12-20 |