| NPI | 1619555760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 83637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0024698) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-03-06 |