| NPI | 1639566128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-52332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-14371) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-02-21 |