| NPI | 1659869824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2021-0956) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL52602) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-05-16 |