| NPI | 1619597630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-03347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 260750) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2024-12-30 |