| NPI | 1679989420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO2264) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015791) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2023-01-25 |