| NPI | 1700266640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD212153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 10772800-1205) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2023-01-17 |