| NPI | 1699240937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 26343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC F05180897) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2022-10-05 |