| NPI | 1639842164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 9170) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-06-23 |