| NPI | 1639378987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 1090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2024041698) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2024-10-24 |